Partial Nephrectomy of a Horseshoe Kidney With Renal-Cell Carcinoma and Cholecystectomy: a Case Report

DergiPark: 819253tmsjAims: Horseshoe kidneys are the most common type of renal fusion anomaly and it may be associated with other anomalies and complications. Our case aims to present the partial nephrectomy of a horseshoe kidney with renal-cell carcinoma and cholecystectomy. Case Report: A sixty-year-old male patient was admitted to our outpatient clinic with a 3 cm suspicious mass in the horseshoe kidney that was detected during an attack of acute cholecystitis. Computed tomography revealed a heteroge- neous hypodense lesion containing millimetric calcific foci of 35x31x33 mm in size at the ventral middle part of the right kid- ney. Partial nephrectomy was performed non-ischemically and then cholecystectomy was performed. Pathological examination revealed stage T1a clear cell renal carcinoma, WHO/ISUP Grade 2 with a negative surgical margin. During follow-up; urea, creatinine, and glomerular filtration rate were found to be normal. Conclusion: Horseshoe kidneys are fairly common among renal anomalies. Cholecystectomy following non-ischemic partial nephrectomy for a tumor in the horseshoe kidney is a rare case

Case Report of An Incidental Unicentric Castleman Disease

DergiPark: 889347tmsjAims: To emphasize the hardship of diagnosing Castleman disease and present a potential treatment method. Case Report: A sixty-three-year-old male patient was admitted to the outpatient clinic with an attack of acute cholecystitis. The patient’s abdominal computed tomography revealed an incidentally detected lipid dense solid mass (64x53x37 mm) at the level of right renal hilum with 29x13 mm solid components in the middle. The patient was admitted to the urology department and underwent surgery where the mass was totally excised due to suspicion of a malignancy (liposarcoma). Histopathological examination later on resulted with unicentric Castleman disease, hyaline vascular subtype. Conclusion: Since unicentric Castleman disease has an asymptomatic clinical course and is quite rare, it is necessary to rule out many potential possibilities before reaching a proper diagnosis. However, unicentric Castleman disease usually exhibits a good prognosis after the removal of the affected lymph node. Still, Castleman disease should be a candidate considered in the differential diagnosis of patients with incidentally discovered lymphadenopathy. On the whole, for a better understanding of underlying pathophysiology, there still lies a gap to be filled with knowledge acquired through further studies

Can Hematological Parameters Play a Role in the Differential Diagnosis of Adrenal Tumors?

There have been few studies reported with conflicting results in the use of neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), redcell-distribution-width (RDW), etc. for predicting prognosis and differential diagnosis of adrenal tumors. The aim of this study is to investigate the role of inflammatory markers through a complete blood count, which is an easy access low-cost method, for the differential diagnosis of adrenocortical adenoma (ACA), adrenocortical carcinoma (ACC), and pheochromocytoma. The data of patients who underwent adrenalectomy between the years of 2010–2020 were retrospectively analyzed. Systemic hematologic inflammatory markers based on a complete blood count such as neutrophil ratio (NR), lymphocyte ratio (LR), NLR, PLR, RDW, mean platelet volume (MPV), and maximum tumor diameter (MTD) were compared between the groups. A statistically significant difference was found between the three groups in terms of PLR, RDW, and MTD. With post-hoc tests, a statistically significant difference was found in PLR and MTD between the ACA and ACC groups. A statistically significant difference was found between the ACA and pheochromocytoma groups in PLR and RDW values. In conclusion, it could be possible to plan a more accurate medical and surgical approach using PLR and RDW, which are easily calculated through an easy access low-cost method such as a complete blood count, together with MTD in the differential diagnosis of ACC, ACA, and pheochromocytoma